Anti-T cell monoclonal antibodies(OKT series. OKT4a, OKTSA, OKT)1) immunoperoxidase technique study for the presence of T cells in cutaneous lesions from four patients with erythema multiforme showed that most dermal and epidermal lymphoid cells were reactive with monoclonal antibodies to anti-pan T cell (l3KT11) in this semiquantitative assay. In the dermis most of the perivascular lirmphoid infiltrates were reactive with anti-helper/inducer T cell antibody, but in the epidermis and in the derrnopidermal interface the predominant cells were identified as suppressor/cytotoxic T cells. The histologic and immunopathologic changes in erythema multiforme appear to be due in part to cellular immune rnechanisms with the lyrnphocyte as the predominant effector cell. But complex interplays with other humoral immune mechanisms might be in work for the development of erythema multiforme.
Antibodies, Monoclonal ; Dermatology* ; Dermis ; Epidermis ; Erythema Multiforme ; Humans ; Immunoenzyme Techniques ; Lymphocytes ; T-Lymphocytes

Nevus Lipomatous cutaneous superficialis (Hoffman-Zurhelle) is distinct clinical entity. A case is reported in which the lesions appeared in childhood and were elevated plaques and nodules in distribution on the tight side of the buttock.
Buttocks ; Nevus*

A clinical study was done on 43 patients witb basal cell carcinoma encountered in the Department of Dermatology, Busan National University Hospital during the past 10-years period frorn January 1968 to December 1977. Tbe results were summarized as follows: 1) Of 43 patients, 15 ceses were male and 28 cases were female with ratio of 1: 1.87. 2) Age incidence ranged frorn 15 years to 87 years with the highest incidence rate in the age group 40-49 years and incidence rate increased remarkbly in numlxr after over 40 years of age. Average age was 55 years. 3) The most common site was face occuring in 39 casts(90.7%), comprising 18 cases on nose, 12 cases on eyelids, 6 cases on cheeks, each 1 case on forehead, upper lip and auricle. 4) Noduloulc rative lesion was most common, otscrved in 29 cases(67.4%), nodular lesion in 9 cascs(20.9%), and pigmented lesion in 5 csses(11.6%). 5. The ratio of basal cell carcinoma was 1:1.2. 6) Three cases of precancerous states including 2 cases of xeroderma pigmentosa and 1 case of irradiated skin lesion were observed.
Busan ; Carcinoma, Basal Cell ; Cheek ; Dermatology ; Eyelids ; Female ; Forehead ; Humans ; Ichthyosis ; Incidence ; Lip ; Male ; Nose ; Skin

A mediastinal mass was aspirated by fluoroscope-guided fine needle aspiration biopsy in a 47 years old female patient. The first aspiration smears were not diagnostic, because of hemorrhagic background and cell paucity. On the second aspiration, the smears were composed of some clusters of benign epithelial cells in hemorrhagic background. Cells were arranged in mostly solid sheets and tended to form glandular lumina in part. Their nuclei were round and vesicular. Nucleoli were not prominent. These findings were suggestive of benign glandular tissue, which was finally confirmed as mediastinal thyroid gland by open thoracotomy specimen.
Biopsy ; Biopsy, Fine-Needle ; Epithelial Cells ; Female ; Humans ; Middle Aged ; Necrosis* ; Nephritis* ; Risk Factors* ; Thoracotomy ; Thyroid Gland

A case of malignant melanoma developed from giant congenital pigmented nevus in a seven year old girl was reported. Since the identification of benign juvenile melanoma, the distinct rarity of true cutaneous malignant melanoma in infants and children has become generally recognized. In giant congenital pigmented nevus, the malignant melanoma as a rule arises deep in the dermis. In this case, the histopathologic finding shows no junctional activity in epidermodermal juction other than ordinary nevocellular nevi, but some nevus cell nests and mild inflammatary cell infiltration in the upper dermis. And in the deep dermis, well marginated but not encapsuIated huge tumor mass, in which variable sized, pleomorphic, several vigorous mitotic figures in predominantly cuboidal cells and bizarre giant cells, which was thought to be developed from giant congenital pigmented nevus. The few recorded cases of fatal cutaneous malignant melanoma in early life are of two types: those arising in giant congenital pigmented nevi and ordinary small nevi, de novo including small nevus. The former account for between 22% and 40% of the total. This case is one of the reported 20 cases in the world.
Child ; Dermis ; Female ; Giant Cells ; Humans ; Infant ; Melanoma* ; Nevus ; Nevus, Pigmented*

Dermatitis Herpetiformis rarely in childhood, and certain features of the disease in children differ from its manifestations in adults. Juvenile dermatitis herpetiformis appears not to be the same disease as the typical dermatitis herpetiformis of adults. Juvenile dermatitis herpetiformis has been described as a predomimantly bullous disease, but rarely papulovesicular eruptions. This bullous eruption in children must be considered in the several entities such as bullous pemphigoid and erythema multiforme. Juvenile bullous dermatitis herpetiformis has not responded routinely to sulfapyridine and sulfone therapy. A 15-month-old child whose skin lesions fulfilled clinical, histologic, and therapeutic criteria for Juvenile dermatitis hepetiformis is reported. The skin lesions showed bullous eruptions and also complained of severe itching sensation different from bullous Juvenile dermatitis herpetiformis.
Adult ; Child ; Dermatitis Herpetiformis* ; Dermatitis* ; Erythema Multiforme ; Humans ; Infant ; Pemphigoid, Bullous ; Pruritus ; Sensation ; Skin ; Sulfapyridine

The clinical findings in the Vogt-Koyanagi-Harada syndrome ae reviewed and eight cases reported emphasizing the cutaneaus changes. The syndrome consists of symptoms of poliosis, vitiligo, alopecia, meningeal irritation sign, nontraumatic uveitis, and dysacousia. Meningeal or ocular symptons usually appear first, but in some patients thc cutanious changes have been observed beforc the uveitis. The etiology rernains unsettied, but an allergic mechanism or a virus infection is favaveci by most observers. Early diagnosis is important because ocular mobidity can be reduced significantly in some patients if treated in the early stages. During the course of treatment of our patients, corticosteroid is appeared to be the most effective drug for this uncertain etiologic syndrome and this fact may eventually support. the theory nf autoimmue mechanisn. The daily does of corticosteroid is prednisolone 60mg and the duration of administration is from 15 days to 2 months, after that the dose is graclually decreased in relation with the degree of symptoms. The ophthalrnologic symptoms were markedly improved 10 days after the administvation of prednisolonc. The purpose of this report is to emphasize the cutaneous findings in this syndrome, to point out that the cutaneous manifestations may lead to establishing tne diagnosis and on the basis of that, those patients can be received prompt, suitable treatment to avoid the grave ocular morbidity.
Alopecia ; Diagnosis ; Dronabinol ; Early Diagnosis ; Humans ; Prednisolone ; Uveitis ; Uveomeningoencephalitic Syndrome ; Vitiligo

Mycobacteriosis cutis is largely classified to localized forms and exanthematous forms and it is subdivded into five diseases in detail, each. They are 1) primary tuberculous complex, 2) lupus vulgaris, 3) tuberculous verrucosa cutis 4) scrofulo derma, and 5) tuberculosis cutis orificialis in localized ferms and 1) tuberculous miliaris disseminata, 2) lupus miliaris disserninaia faciei, 3) papulonecrotic tuberculid, 4) lichen scrofulosorom and 5) ervthema induratum in exanthematous forms.Rich(1944) insisted on that, the pathogenesis of cutaneous tuberuculosis was essen tially the sarne as that for tuberculosis in general. He said that aII forms of cutaneous tuberculosis were produced by the local action of the bacilus of tuberculosis. In the formerly termed true tuberculosis such as lupus vulgaris, the microorganisrns were found in varing numbers in the lesions, and animal inoculations of tissue were successful, In other forms represented by the tuberculids, the bacillus of tuberculosis was found only in the earilest stages before the true clinical and histological picture had developed, Its short lived existence in this forms was explained by the allergic statc of the tissues and this fact exnlained the failure to find the microorganisms in the lesions, or reproduced the affection by inoculations in animals, in cases sufficiently developed to be recognizable clinically and histologically. The other generally accepted view is that the mycobacteriosis cutis, especially the types in the category of tuberculids are caused by the hematogenous dissemination of tubercle bacilli from a focus, often extrapulmonary in location, into the skin, where they are rapidly destoryed. spiet and Roeckie(1960) agreed with above menitioned plausible theories with the background of their hypothesis, that was the skin was hyperegic, And Miescher(1951) also insisted that, skin had a decreased immunologic resistance. But according to Flegel(1957), if the skin was in a state of hyperegic reaction, the focus from which the dissemination was taking place was also should be in a hyperegic state and vice versa should be right, And moreover, Suizberger(1940) declared that whenever microorganisms or their products were being overcome or neutralized by local lmmunologic reactions, tubercles or tubercles or tuberculoid structures had a tendency to appear. So the theories of different immunologic state between the skin and focus were discarded. After that many authors proposed three factors against a tuberculous etiology of tuberculids. First, inoculation of tissue from lesion into guinea pigs and culturing of such tissue have given no evidence for tuberculosis. Second, active tuberculosis occurs no greater frequency in patients with tuberculids than in the general population. Third, tuberculids does not respond to antituberculous treatment but responds to the adminiatration of corticosteroids. According to Eberhartinger(1963), Schneider and Undeutsch(1965), in erytbema induraturn the primary event is a vasculitis of subcutaneous arteries and veins. And any fat necrosis following vascular damage can develop a tubereuloid appea- rance. Lever(1967) declared with self confidence that it was a relic of the times- when a tuberculoid histology was tantamount to tuberculosis. In this condition we decided to clarify that whether the mycobacteriosis cutis, especially the disease in the category of tuberculids, could be originated from mycobacteria tuberculosis in fact or not. Eleven patients, whose clinical diagnosis were skin tuberculosis or very similar to those diseases such as erythema. nodosum, were biopsied by 5mm puncher after 2% procaine injection on their two of skin lesions, the early one for the culture of tubercle bacilli and the oId one for histopathological study, on the O.P.D. of dermatologic department in Severance Hospital. Those biopsied material of early lesion was digested with proper amount of 4% NaOH and fragmented in tissue grinder about 10 minutes. After that, it was centrifuged in rotating speed of 3,500 r.p.m. for 30minutes, and neutralized by 8% HCl after adding phenol red drop by drop. Again it was centrifuged by same as previous method and its supernatant was discarded. The remnants of precipitin was inoculated on Ogawa's nutrient tuberculous media in incubator at 37C. Finally the acid-fast tubercle bacilli have been grown on the Ogawa's media three months after its first inoculation. The inoculation material was biopsied from the patient of eighteen year-old girl, whose clinical and histopathological diagnosis was erythema induratum. From the result of this study, we got the strong confidence that in spite of many authors powerful countertheories and the extremely poor harvesting of its culture, the erythema induratum can be or in evidently caused from mycobacterium tuberculosis. It may be early days yet to say that erythema induratum is originated fromtubercle bacilli but it is considered to be a truth in Korea, with the result of this study.
Adrenal Cortex Hormones ; Animals ; Arteries ; Bacillus ; Diagnosis ; Erythema ; Erythema Induratum ; Fat Necrosis ; Female ; Guinea Pigs ; Humans ; Incubators ; Korea ; Lichens ; Lupus Vulgaris ; Mycobacterium tuberculosis ; Phenolsulfonphthalein ; Procaine ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous* ; Vasculitis ; Veins

On the basis of stastistical awlysis trend of increase in syphilis patients in Korea closely resembles that reported in other countries. Among these patients, it should be noticed that thy were highly infectious, showing early latent syphilis. Nevertheless, the available diagnstic test for syphilis has only been limited to the Non-treponemal antigen test. Moreover not only schedules employing in the treatment f disease have been different among physicians but the follow up test for each patient bas been quite impossible. In these respects, the author strongly suggests that the effective measures for the prevention and treatment of syphilis will be required as a national policy.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Korea* ; Syphilis* ; Syphilis, Latent

Xeroderma pigmentosum is characterized by sunlight sensitivit.y, autosomal recessive inheritance, and multiple cutaneous malignancies, usually basal and squamous cell carcinomas. In this work the effects of bleomycin and topical 5-fluorouracil on basal and squamous cell careinomas appearing in the patient of xeroderma pigmentosum were studied and followed up for two years. The material was a 50 year old female patient of xeroderma pigmentosum associated with basal and squamous cell carrinomas occuring in the exposed area, and its mixed tumor in the nose for thirty years. Duringfirst admission blecmycin was given intravenously in a dosage of 15 mg every other day or twice a week for basal cell carcinomas in the exposed area and mixed tumor in the nose. The total amount of bleomycin given was 315 mg. A year later another squamous cell carcinomas developed on the exposed area. She was treated with topical application of 5% 5-fluorouracil cream daily for 40 days during second admission. The results obtained are summarized as follows: l. The effect of bleomycin is more effective in the squamous cell carcinoma than in the basal cell carcinoma which recurred after 2 years. 2. Topical therapy of 5% 5-fluorouracil cream appeared almost complete effectiveness to the squamous cell carcinoma.
Bleomycin ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Female ; Fluorouracil ; Humans ; Ichthyosis* ; Middle Aged ; Nose ; Skin Neoplasms* ; Skin* ; Sunlight ; Wills ; Xeroderma Pigmentosum*